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Individual
MICHAEL RENEMA
Active
Individual
MICHAEL RENEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501007076
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11562931
CAQH
MI
01
—
650H216390
BCBS
MI
01
—
OH25822
BCBS TRUST PPO
MI
01
—
P00082800
RAILROAD
MI
Enumeration date
07/25/2006
Last updated
07/20/2011
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